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·威尔布兰德因子用于预测晚期慢性肝病不同临床阶段的结果

Nina Dominik^1,2, Bernhard Scheiner^1,2,3, Alberto Zanetto⁴

¹Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.

Alimentary pharmacology & therapeutics

|March 14, 2024

概括

·威尔布兰德因子 (VWF) 在晚期慢性肝病 (ACLD) 阶段逐渐增加. 一个C-反应蛋白 (CRP) 和VWF模型显示了补偿ACLD的预后价值,与侵入性措施相比.

科学领域:

肝病学肝病学是一种肝病学.
生物标志物发现发现
临床预后临床预后

背景情况:

·维勒布兰德因子 (VWF) 的预后表现可能在晚期慢性肝病 (ACLD) 临床阶段有所不同.
在整个ACLD频谱中调查VWF和生物标志物演变对于理解特定阶段的预后效用至关重要.

研究的目的:

调查VWF和其他生物标志物在ACLD全谱的演变.
在ACLD患者中评估VWF和其他生物标志物的特定阶段的预后效用.

主要方法:

对维也纳ACLD患者的回顾性分析,包括肝静脉压梯度 (HVPG),C反应蛋白 (CRP) /VWF水平和结果的数据.
由D'Amico等人定义的ACLD分期. ;包括来自帕多瓦的外部验证队列.

主要成果:

在所有ACLD阶段,VWF水平逐渐增加,与HVPG,MELD或CRP不同.
在补偿ACLD (cACLD) 中,VWF预测了肝脏衰减/肝脏相关死亡,但在不补偿ACLD (dACLD) 中没有.
一种非侵入性CRP/VWF模型在cACLD中表现出与基于HVPG的侵入性模型相比的预后性能,并得到了外部验证.

结论:

在ACLD阶段,VWF是一个持续增长的生物标志物,在cACLD中具有显著的预后价值.
一个基于CRP/VWF的模型为预测cACLD的结果提供了与侵入性HVPG测量相当的替代方案.
由CRP和VWF表示的炎症是cACLD的关键驱动因素,突出了实验室间VWF标准化的需要.

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